Neuronal signal system for behavior modification

ABSTRACT

The present invention further relates to a system for communicating movement information to an individual, comprising means for providing a first neuronal stimulation signal to be applied to the cortex of an individual adapted to provide a movement cue for the individual and means for providing a second neuronal stimulation signal to be applied to the cortex of the individual adapted to provide proprioceptive information to the individual, wherein the first and the second neuronal stimulation signal are adapted to be applied together to the cortex of the individual.

1. TECHNICAL FIELD

The present invention relates to signal and data processing systems forproviding neuronal stimulation signals to an individual that may be usedfor behavior and, in particular, movement modification.

2. TECHNICAL BACKGROUND

The present application is directed to neuronal stimulation systems forbehavior and movement modification, in particular, in the context of thetreatment of neurological movement impairments.

Neurological diseases such as Parkinson's disease (PD), essential tremoror dystonia may severely degrade the movement and coordination abilitiesof affected patients. It is well known, that certain symptoms of suchdiseases can be successfully treated or at least ameliorated viastimulation of the nervous system of the affected patients.

For instance, deep brain stimulation (DBS) systems send electricalimpulses, through implanted electrodes, to specific areas/nuclei of thebrain to treat such symptoms. Conventionally, in the treatment of PDsymptoms, these nuclei may include the globus pallidus interna, thethalamus and/or the subthalamic nucleus. It is known that DBS of theglobus pallidus interna improves motor function while DBS of thethalamus improves tremor but has little effect on bradykinesia orrigidity. Further, DBS of the subthalamic nucleus is associated withreduction in PD medication.

US 2007/0250134 A1 relates to an implantable medical device fordelivering different electrical stimulation therapies to the nervoussystem of a patient in order to suppress different symptoms of PD. Onesuch electrical stimulation therapy is configured to suppress the socalled freezing of gait (FOG) symptom while another such electricalstimulation therapy is configured to suppress other PD symptoms such astremor, bradykinesia or rigidity. At any given time, the medical devicedelivers the electrical stimulation therapy according to a current setof therapy parameters. The therapy parameters may change over time. Themedical device, or another device, periodically determines an activitylevel of the patient, and associates each determined activity level withthe current therapy parameter set. In addition to recording FOG eventsand determining activity metric values based on such events, the medicaldevice may also control delivery of a stimulus to terminate FOG. Forexample, if stimulation leads are implanted proximate to the spinal cordor peripheral nerves of the patient the medical device may controldelivery of a stimulation perceivable by the patient to prompt thepatient to walk, thereby terminating FOG. The stimulation may berhythmic, e.g., may approximate the rhythm of walking, which may promptthe patient to walk and thereby terminate the FOG.

The recent publication “Sensory Electrical Stimulation Cueing May ReduceFreezing of Gait Episodes in Parkinson's Disease”; L. Rosenthal et. al.;Hindawi Journal of Healthcare Engineering; 2018, Article ID 4684925describes how skin surface electrodes can be used to provide a fixedrhythmic sensory electrical stimulation signal to PD patients in orderto reduce the time taken to complete a walking task and to reduce thenumber of FOG episodes occurring when performing the task.

A different approach for treatment of movement impairments consists inrhythmic auditory cueing. The recent review article “Effect of rhythmicauditory cueing on parkinsonian gait: A systematic review andmeta-analysis”; S. Ghai et al.; NATURE SCIENTIC REPORTS; (2018) 8:506;DOI:10.1038/s41598-017-16232-5 provides a systematic overview on usingrhythmic auditory cueing to enhance gait performance in PD patients.

Moreover, US 2019/0030338 A1 relates to an implantable medical devicethat is capable of determining whether a patient is susceptible to FOGevents during ambulatory movement without the patient actuallydemonstrating an episode of FOG. The implantable medical device senses,via one or more electrodes, a bioelectrical signal of a brain of thepatient while the patient performs a movement associated with FOG. Theimplantable medical device then determines, based on the sensedbioelectrical signal, whether the patient is susceptible to FOG whilethe patient is not experiencing an episode of FOG. Further, upondetecting the movement associated with FOG, the implantable medicaldevice delivers an electrical stimulation therapy via a DBS electrode tothe patient configured to suppress FOG.

However, the electrical stimulation systems known from the prior arthave various deficiencies. For instance, auditory cueing treatment forpatients suffering from a movement impairment may degrade the listeningcapabilities of the patient and distract him from other relevant soundsproviding crucial information on his environment.

Further, providing electrical stimulation signals via skin surfaceelectrodes requires bulky electronic equipment to be carried by thepatient as well as continuous maintenance of the skin surface electrodesthat may degrade and/or detach from the skin due to external moisture orbody moisture.

Moreover, conventional DBS systems can only be used to provideunspecific neuromodulation signals that for instance are configured tosuppress FOG events or tremor. However, such systems completely lack thecapability of continuously enhancing the movement of the patient after aFOG event has been suppressed in terms of regularity, balance and/orbody posture.

It is thus the problem of the present invention to provide novelneuronal stimulation systems that improve the known systems such thatthe above outlined disadvantages of the prior art are at least partiallyovercome.

3. SUMMARY OF THE INVENTION

The above-mentioned problem is at least partly solved by the subjectmatter of the independent claims of the present application. Exemplaryembodiments of the invention are the subject of the depended claims.

In one embodiment, the present invention provides a system forstimulating the sensory cortex of an individual, comprising: means forobtaining a neuronal stimulation signal adapted to provide a movementcue for the individual and means for transmitting the neuronalstimulation signal to an electric contact of a neuronal stimulationelectrode that is implanted into the brain of the individual.

For example, the neuronal stimulation electrode may already be implantedinto the brain of the individual for a purpose different from providingthe movement cue.

In this manner, no additional electrode has to be implanted but anexisting one can be used for interfacing the system provided by thepresent invention.

For instance, the neuronal stimulation signal may be adapted to elicit asensory percept, preferably conscious, in the cortex of the individual.The sensory percept may for example be elicited in in at least on of: asomatosensory cortex area; a visual cortex area and an auditory cortexarea. By using such a system, sensory percepts can directly be elicitedin the cortex of an individual without stimulation of the sensory organsand or the peripheral nervous system.

For instance, the system provided by the present invention can beinterfaced with a DBS electrode that is already implanted into the brainof an individual for the purpose to stimulate the thalamus or thesub-thalamic nucleus with a neuromodulation signal (e.g. for treatmentof PD symptoms such as tremor). In this way, the provided system canprovide the movement cue via stimulating afferent sensory axons that runin the vicinity of the thalamus and project into the sensory cortex ofthe brain. Such a system thus allows to provide various types ofmovement cues directly to the cortex without requiring additionalsensory stimulation equipment such as earphones, skin surface contacts,dedicated neuronal stimulation electrodes etc. but makes use of electriccontacts that are already available in the vicinity of such afferentsensory axons.

In other words, patients that have already been implanted with aneuronal stimulation electrode for a different purpose can easily alsobe provided with movement cues via interfacing their already presentimplant with the neuronal stimulation systems provided by the presentinvention without undergoing additional surgical procedures or requiringto carry additional equipment.

In some embodiments, the neuronal stimulation electrode may be implantedfor the purpose of at least one of: deep brain stimulation; neuronalsensing; an open-loop or closed-loop combination of deep brainstimulation and neuronal sensing; treatment of Parkinson's disease, ofepilepsy, dystonia and/or of tremor as well as neuronal communication.

Further, in some embodiments, the electric contact to which the neuronalstimulation signal is transmitted to may not be used for the purposethat is different from providing the movement cue. For instance, if amulti-contact DBS electrode is used for the purpose of applying aneuromodulation therapy such as a treatment of PD symptoms typicallyonly a subset of its electric contacts (e.g. one contact) is actuallyused for applying the neuromodulation therapy stimulation signal. Theremaining unused contacts can thus be used to stimulate afferent sensoryaxons targeting the sensory cortex of the individual and thereby toprovide a sensory movement cue or other movement information to thepatient.

Alternatively, an electric contact that is used for applying theneuromodulation therapy can also be used in an alternating manner. Forinstance, the movement cue may be provided during periods wherein theelectrode is not used for applying the neuromodulation therapy (e.g. thepurpose that is different from providing the movement cue).

Further, in some embodiments, the stimulation system provided by thepresent invention may also comprise means for operating the neuronalstimulation electrode according to its purpose. For instance, if theneuronal stimulation signal providing the movement cue is applied via anelectric contact of a DBS electrode implanted for treatment of PD, thestimulation system provided by the present invention may also comprisethe necessary means to generate, amplify and/or apply theneuromodulation therapy signal via the DBS electrode.

In this manner, system components such as a power supply, communicationinterfaces, memory, signal processing circuitry, etc. can be shared andbe integrated into a single neurostimulation device providing both, theneuromodulation therapy signal and the neuronal stimulation signal thatis adapted to provide the movement cue. This reduces, cost, complexityand power consumption of the combined stimulation system compared tousing largely independent stimulation systems for each purpose alone.

Further, in some embodiments, the neuronal stimulation signal maycomprise a signal or a pulse train signal designed to be perceived bythe individual as periodic.

For instance, the neuronal stimulation signal may be designed such thatit elicits periodically appearing sensory percept in the cortex of theindividual. For example, the neuronal stimulation signal may elicit aperiodically appearing pressure sensation of a body part such as a leg,a foot, a hand, a tongue etc. of the patient. Alternatively oradditionally, auditory and/or visual sensory percepts may be elicited ina periodic manner.

For instance, such a signal designed to be perceived by the individualas periodic may comprise burst pulses, wherein each burst may comprise aseries of signal spikes. In this case, the perceived periodicity of sucha signal may then correspond to the repetition rate of the burstspulses. For instance, a burst pulse may be 300 ms long and may comprise42 signal spikes each having an amplitude of 1 mA.

In some embodiments, the periodicity of such sensory percepts maycorrespond to a characteristic of a movement related to the movement cueprovided by the neuronal stimulation signal, such as a waking pace, abreathing rhythm, a dancing rhythm etc.

In this manner, the neuronal stimulation signal may be used to provideguidance to a patient desiring to perform a periodic or rhythmicmovement or behavior such as walking, breathing and/or dancing.

Further, in some embodiments, the means for transmitting the neuronalstimulation signal may be further configured to control a frequency, apulse width, a pulse shape and/or an amplitude of the neuronalstimulation signal transmitted to the electric contact of the neuronalstimulation electrode.

In this manner, a great variety of neuronal stimulation signals can betransmitted and be used to provide a great variety of different movementcues to the individual e.g. via elicited sensory percepts in the sensorycortex. Moreover, by controlling signal parameters such as thefrequency, the pulse width, the pulse shape and/or the amplitude, theneuronal stimulation signal and thus also the provided movement cue canbe tailored to the individual, e.g. via carrying out calibration andlearning procedures specific to the individual.

For instance, the means for transmitting may be further configured tocontrol a movement speed, a pace regularity and/or a balance of theindividual via the frequency the pulse width, the pulse shape and/or theamplitude of the neuronal stimulation signal.

In this manner the provided system enables the design of closed-loopmovement enhancement systems, wherein one or more characteristics of amovement of the individual are determined and then used to provide afeedback signal for the neuronal stimulation signal. In this way, thesensory quality of the provided movement cue can dynamically be adjustedto varying external conditions and/or changing movement characteristics.

Further, the means obtaining the neuronal stimulation signal maycomprise means for selecting at least one neuronal stimulation signalsto be transmitted to the neuronal stimulation electrode. For instance,the means for selecting may be adapted to select at least two differentneuronal stimulation signals having different frequencies.

In this manner the individual, a therapy supervisor and/or an autonomouscontrol logic may select different stimulation signals in response todifferent requirements. For instance, the individual may select adifferent signal frequency depending on whether he wants to carry outthe movement at a slow or a fast pace. In addition, the intensity of themovement cue may be adjusted to be always clearly perceivable.

In some embodiments, a first neuronal stimulation signal may be adaptedto control the movement speed, the pace regularity and/or the balance ofthe individual and a second neuronal stimulation signal is adapted tocounteract a temporary movement impairment of the individual.

For instance, the second neuronal stimulation signal may be adapted toprovide a FOG breakout signal to the individual and the first a gaitpacemaker signal. In this manner the same stimulation system using thesame neural interface (e.g. a DBS electrode) can be used to end a FOGperiod and to provide a gait pacemaker signal enhancing gait quality andreducing the occurrence frequency of FOG events.

Further, the means for transmitting the neuronal stimulation signal maybe adapted to transmit at least two different neuronal stimulationsignals to two different contacts of the neuronal stimulation electrode,preferably simultaneously.

In this way, auxiliary information can be provided to the individualtogether with the movement cue. For instance, while the movement cue isapplied via the first electric contact, the second contact may be usedto communicate a balance signal, information about the body posture, theposition of the individual with respect to a reference position or awarning signal.

In another embodiment, the present invention provides a system forcommunicating proprioceptive information to an individual, comprising:means for obtaining information about the body posture of theindividual, means for determining, based on the obtained information, aneuronal stimulation signal to be applied to at least one afferent axontargeting at least one sensory neuron in the cortex of the individual,wherein the determined neuronal stimulation signal corresponds to theproprioceptive information to be communicated and means for transmittingthe determined neuronal stimulation signal to a neuronal stimulationmeans of the individual adapted to apply the determined neuronalstimulation signal to the at least one afferent axon.

Such a system can be used to provided proprioceptive informationdirectly to the cortex of an individual either in order to substituteproprioceptive sensations that were impaired by a neurological diseaseor a lesion of the nervous systems of the individual or to provideartificial proprioceptive information which has no physiologicalcounterpart. For instance, the determined neuronal stimulation signalmay be configured to elicit a conscious or subconscious sensory perceptin the cortex of the individual.

In contrast to the prior art the present invention enablessupplementation of natural afferent proprioception by artificial meansto aid the individual in the integration of movement, posture andproprioception.

For example, the information about the body posture may comprise atleast one of:

-   -   a. information about an articulation state of a joint of the        individual;    -   b. information about a flexing angle of a joint of the        individual;    -   c. information about the balance of the body of the individual;    -   d. information about a tone of a muscle of the body of the        individual;    -   e. information about a position of a part of the body of the        individual with respect to a reference position.    -   f. information about a surface contact of a part of the body of        the individual.

Further, the means for obtaining the information about the body postureof the individual may comprise at least one of:

-   -   a. a pressure sensor;    -   b. a tension sensor;    -   c. a balance sensor;    -   d. an acceleration sensor;    -   e. a temperature sensor;    -   f. an image sensor;    -   g. a force sensor;    -   h. a distance sensor;    -   i. an angle sensor;    -   j. a speed sensor;

By using one or more of such sensors an accurate model of the bodyposture of the individual may be determined and be used to determine atailored neuronal stimulation signal that is adapted to communicateprecise and reliable proprioceptive information directly to the cortexof the individual.

Further, the means for determining the neuronal stimulation signal maycomprise means for accessing a data storing means storing relations,specific for the individual, between a plurality of proprioceptiveinformation and a plurality of corresponding neuronal stimulationsignals.

This embodiment greatly improves the efficiency and flexibility ofcommunicating the desired proprioceptive information to the cortex ofthe individual. For instance, a communication device that interfaceswith or uses the provided system can easily determine and directlytransmit the specific neuronal stimulation signal corresponding to adesired proprioceptive information via stimulation of afferent axonstargeting sensory neurons in the cortex of the individual.

For instance, in some embodiment of the present invention, the storedrelations between the proprioceptive information and the correspondingneuronal stimulation signals may be based at least in part on one ormore of: spatial information for the at least one afferent axon, spatialinformation for the at least one neuronal stimulation means, neuronalconnectivity information for the at least one afferent axon, an electricfield distribution associated with the neuronal stimulation means,functional neuroimaging data for the individual, diffusion tensorimaging data for the individual, neuroanatomical reference data beingrelevant for the individual, cortical excitation data for theindividual, sensory perception data for the individual, behavioral databased at least in part on subjective experiences of the individualand/or an optimization procedure for maximizing the number ofproprioceptive information that can be perceived by the individual.

Further, the stored specific relations may be based at least in part onproprioceptive learning data for the individual, the learning dataassociating the plurality of proprioceptive information with theplurality of corresponding neuronal stimulation signals.

Further, the means for determining the neuronal stimulation signal maycomprise means for determining an excitation probability of the at leastone afferent axon and/or the at least one sensory neuron based at leastin part on the obtained spatial information, preferably by using afinite element method and/or a neuronal compartment model.

In this manner active electric properties (e.g. the non-linear neuronalexcitability) of the at least one axon can be taken into account by thesystem when determining the neuronal stimulation signal, thereby furtherenhancing the specificity and accuracy of the proprioceptive informationto be communicated.

In another embodiment, the present invention provides a system forcommunicating movement information to an individual, comprising meansfor providing a first neuronal stimulation signal to the cortex of anindividual adapted to provide a movement cue for the individual andmeans for providing a second neuronal stimulation signal to the cortexof the individual adapted to provide proprioceptive information to theindividual, wherein the first and the second neuronal stimulation signalare provided together to the cortex of the individual.

In many cases, neurological movement impairments also entail adegradation of physiological proprioceptive information reaching thecortex of the affected individual via the sensory nervous system. Thus,by communicating proprioceptive information together with a movement cuevia a neuronal communication interface the system provided by thepresent invention can substantially enhance the success of movementimpairment therapies.

Similar as for other embodiments discussed above, the first and/or thesecond neuronal stimulation signal may be applied via at least oneportion of a neural stimulation electrode already implanted for apurpose different from communicating the movement information (e.g. forthe purpose of applying a neuromodulation therapy to the thalamus or thesub-thalamic nucleus).

Alternatively, the first and/or the second neuronal stimulation signalmay also be applied via different neural interface means such astranscranial stimulation means, sub-dural electrode arrays, spinal cordstimulation means, optogenic neuronal interface means and/or peripheralnerve stimulation means.

Further, the proprioceptive information conveyed by the secondstimulation signal may be related to a body part of the individual thatis involved in a movement of the individual associated with the movementinformation to be communicated. For instance, the second neuronalstimulation signal comprises one of the following information:

-   -   a. information about an articulation state of a joint of the        individual;    -   b. information about a flexing angle of a joint of the        individual;    -   c. information about the balance of the body of the individual;    -   d. information about a tone of a muscle of the body of the        individual;    -   e. information about a position of a part of the body of the        individual with respect to a reference position    -   f. information about a surface contact of a part of the body of        the individual.

In this manner, the individual can be provided with relevantproprioceptive information that can assist in performing a movement tasksuch as walking, dancing, etc.

Similar to other embodiments discussed above, the first neuronalstimulation signal may comprise a signal (e.g. a pulse train signal)that is designed to be perceived as periodic by the individual.

Further, the means for providing the first and/or the second neuronalstimulation signal may be adapted to control a frequency, a pulse width,a pulse shape and/or an amplitude of the first and/or the secondneuronal stimulation signal and/or adapted to control a relative timingbetween the first and the second neuronal stimulation signal.

In this manner, the provided system can ensure that both neuronalstimulation signals can be applied to the cortex of the individual in amanner that is specific to the individual.

In particular, the second neuronal stimulation signal may be provided ata rate that is more than 2 times, preferably more than 5 times, morepreferably more than 10 times and even more preferably more than 20times larger than a frequency of the first neuronal stimulation signal.

Providing the second neuronal stimulation signal more often than thefirst one allows the individual to use the provided proprioceptiveinformation while performing the movement associated with the movementcue provided by the by the first neuronal stimulation signal.

Further, the second neuronal stimulation signal may be providedquasi-continuously with respect to the first neuronal stimulationsignal, e.g. at a rate that is much larger than a frequency of the firstneuronal stimulation signal.

Similar as for other embodiments discussed above, the provided systemmay further comprise means for obtaining information about the bodyposture of the individual via at least one of:

-   -   a. a pressure sensor;    -   b. a tension sensor;    -   c. a balance sensor;    -   d. an acceleration sensor;    -   e. a temperature sensor;    -   f. an image sensor;    -   g. a force sensor;    -   h. a distance sensor;    -   i. an angle sensor;    -   j. a speed sensor.

Using one or more of such sensors allows the system to obtain preciseinformation on the body posture of the individual. In severalembodiments, the means for obtaining information about the body postureof the individual may be integrated into at least one of the following:

-   -   a. a piece of apparel,    -   b. a piece of footwear,    -   c. a prothesis,    -   d. an orthosis,    -   e. an exoskeleton,    -   f. an autonomous robotic companion,    -   g. a wearable electronic device.    -   h. an implanted device.

Further, the various systems provided by the present invention may alsocomprise means for receiving a neuronal measurement signal correspondingto a neuronal excitation pattern recorded via a neuronal excitationmeasurement device.

Further, the neuronal measurement signal may be received from at leastone of the following:

-   -   a. an electroencephalography, EEG, device;    -   b. a neuro-electrode,    -   c. a deep brain stimulation electrode,    -   d. a sub-dural electrode;    -   e. a sub-dural electrode array;    -   f. a connected wearable device;    -   g. a transcranial excitation measurement device.

By integrating measurements of neuronal excitation patterns the systemsprovided by the present invention can be used for closed-loop and/orneurofeedback applications. For instance, the system may be configuredto receive a signal corresponding to a neuronal excitation patternassociated with a movement intention and/or to motor-sensory informationof the individual.

In this manner, the system could be directly controlled by the mind ofthe individual. For instance, instead of adjusting the walking pace viaa control device such as a smartphone the individual could control thepace by merely thinking of walking slowly or fast. The system would thenrecord the corresponding neuronal excitation pattern and derive therequired stimulation signal parameters (e.g. frequency, pulse widthamplitude etc.) that correspond to the walking pace intended by theindividual. With training the individual can even regain full dynamiccontrol over his walking pace or other movements supported by thesystems provided by the present invention.

In another embodiment, the present invention provides an electronicinformation processing device, comprising a system according to any ofthe embodiments discussed above. For instance, the functionalities ofany of the above systems may be implemented on a general-purpose signalprocessing device such as a smartphone comprising memory, digital andanalog signal processing circuitry as well as interface means (e.g. awireless communication interface) that allows to transmit neuronalstimulation signals to various kinds of neural interface means such as aDBS device.

In another embodiment, the present invention provides a distributedelectronic information processing system, comprising the systemaccording to any of the embodiments discussed above. For instance, somesystem components may not be collocated in a single device but may becommunicatively connected via a wired or wireless communicationinterface.

In another embodiment, the present invention provides a computerprogram, comprising instructions to implement the functionalities of asystem according to any of the embodiments discussed above, when beingexecuted by an electronic information processing device or a distributedelectronic information processing system.

4. SHORT DESCRIPTION OF THE FIGURES

Aspects of the present invention are described in more detail in thefollowing by reference to the accompanying figures. These figures show:

FIG. 1 a diagram illustrating an individual operating a neuronalstimulation system according to an embodiment of the present invention;

FIG. 2 a diagram illustrating a neuronal stimulation electrode forstimulating afferent axons targeting the sensory cortex of anindividual. The neuronal stimulation electrode can be interfaced with aneuronal stimulation system according to an embodiment of the presentinvention;

FIG. 3 a diagram illustrating a therapeutic multi-contactneuromodulation electrode adapted for modulation of brain nucleiassociated with a movement impairment. Unused contacts of the electrodecan be used for stimulating afferent axons targeting the sensory cortexof an individual via a neuronal stimulation system according to anembodiment of the present invention.

FIG. 4A a block diagram of a neuronal stimulation signal generator fordriving a neuronal stimulation electrode which can be interfaced with aneuronal stimulation system according to an embodiment of the presentinvention;

FIG. 4B a block diagram of a neuronal stimulation system according to anembodiment of the present invention;

FIG. 5 a diagram illustrating how a movement cueing channel can beimplemented using a neuronal stimulation system according to anembodiment of the present invention;

FIG. 6 a diagram illustrating exemplary neuronal stimulation signalsadapted to provide a movement cue and a FOG break-out signal;

FIG. 7 a diagram illustrating an individual operating a neuronalstimulation system according to a further embodiment of the presentinvention;

FIG. 8 a diagram illustrating how a proprioceptive information channelcan be implemented using a neuronal stimulation system according to anembodiment of the present invention;

FIG. 9 a diagram illustrating how the proprioceptive information channelof FIG. 8 can be used to communicate information on the articulationstate of a knee joint of an individual;

FIG. 10 a diagram illustrating the relative timing of the movement cuechannel of FIG. 6 and the joint articulation state channel of FIGS. 8and 9 while the individual depicted in FIG. 7 performs a walking task.

5. DETAILED DESCRIPTION OF SOME EXEMPLARY EMBODIMENTS

In the following, some exemplary embodiments of the present inventionare described in more detail, with reference to neuronal stimulationand/or communication systems that can be interfaced with neuronalstimulation electrodes such as deep brain stimulation (DBS) electrodes.However, the systems provided by the present invention can also be usedwith different neuronal stimulation means (e.g. opto-neuronal) that arecapable to stimulate the sensory cortex of an individual e.g. viastimulating afferent axons targeting the sensory cortex. While specificfeature combinations are described in the following with respect to theexemplary embodiments of the present invention, it is to be understoodthat the disclosure is not limited to such embodiments. In other words,not all features have to be present for realizing the invention, and theembodiments may be modified by combining certain features of oneembodiment with one or more features of another embodiment.Specifically, the skilled person will understand that features,components and/or functional elements of one embodiment can be combinedwith technically compatible features, components and/or functionalelements of any other embodiment of the present invention.

FIG. 1 depicts an individual too, e.g. a PD patient, that has beenimplanted with a neuronal stimulation electrode 120 such as a DBSelectrode that may have multiple independently controllable electriccontacts, as illustrated in FIG. 3 below. For instance, the neuronalstimulation electrode 120 may be already implanted into the brain of theindividual too for the purpose of providing a neuromodulation therapyfor certain PD symptoms such as tremor, dystonia and/or rigidity.However, the neuronal stimulation electrode 120 may also be implantedfor other purposes such as for the purpose of neuronal communicationand/or treatment of other movement impairments and neurological diseasessuch as epilepsy. Alternatively, the electrode 120 may also be implanteddedicated as an interface for the systems provided by the presentinvention.

The individual 100 may be further equipped with a neuronal stimulationsignal generator device 110 that may be arranged on the head of theindividual 100 or somewhere else on or in the vicinity of the body ofthe individual 100. The neuronal signal generator 110 may be in wirelesscommunication (e.g. via a Bluetooth or similar wireless interface) witha control device 130, that may be implemented by a smartphone or asimilar electronic information processing device. Depending onimplementation details the systems provided by the present invention maybe implemented by the control device 130, the neuronal signal generator110, an additional system (such as the system 400 of FIG. 4B) or acombination thereof. For instance, the control device 130, the signalneuronal signal generator device 110 or both may be provided withapplication specific hardware and/or software modules comprisingcircuitry and/or software instructions to implement a system accordingto the present invention.

The control device 130 may provide the individual with a user interfaceto adjust the neuronal stimulation signals and/or the neuromodulationtherapy applied via the signal generator 110 and the neuronalstimulation electrode 120. For instance, the individual 100 may adjustsignal parameters such as a signal frequency, a pulse width, a pulseshape and/or a signal amplitude. For example, the individual may use thecontrol device 130 to select a perceived periodicity of a movement cueprovided by a neuronal stimulation signal to the cortex of theindividual 100. For example, if the movement cue is used to provideguidance to the individual 100 during a movement such as walking, thecontrol device 130 may be used to select and set a movement paceassociated with the perceived periodicity of the movement cue.

FIG. 2 depicts a diagram illustrating a neuronal stimulation electrode120 for stimulating afferent axons 230 targeting sensory neurons in thecortex of a human brain. The afferent axons 230 may target differentareas 210, 220 of the cortex that may be related to different sensorymodalities (e.g. touch, temperature sense, vision, hearing, etc.) and/ordifferent body regions (e.g. cochlea, retina, hand, tongue, foot etc.)from which the respective sensory modality is perceived by therespective area of the cortex. For instance, the cortical area 210 maybe a somatosensory area of the right foot and the cortical area 220 maybe a somatosensory area of the left hand.

The afferent axons 230 are connected via synapses (not shown) with theirrespective target neurons in the respective sensory area 210, 220. Forinstance, the axons 230 may be thalamocortical axons relaying sensoryinformation from the thalamus to the cerebral cortex. The neuronalstimulation electrode 120 may comprises a plurality of independentlycontrollable electric contacts (see FIG. 3 below) that may be arrangedin the vicinity of a bundle of afferent axons 230 targeting the sensoryareas 220 and 210 of the cerebral cortex.

In the illustrated example, the neuronal stimulation electrode 120 isconnected to a neuronal stimulation signal generator 110, which isadapted to apply neuronal stimulation signals to the afferent axons 230,e.g. via independently controllable electric contacts of the neuronalstimulation electrode 120. In addition, the neuronal stimulationelectrode 120 may further comprise a wireless interface for interfacingthe signal generator 110 with a neuronal stimulation system which may beadapted to obtain and/or determine the waveform and/or signal parameters(e.g. pulse width, pulse shape, frequency, amplitude, number of pulsesetc.) of the neuronal stimulation signal that is generated and appliedby the signal generator 110 to the afferent axons 230 via thestimulation electrode 120.

For instance, the neuronal stimulation system provided by the presentinvention may determine the waveform and/or signal parameters of theneuronal stimulation signal such that a desired sensory percept iselicited in a desired area of the sensory cortex of the individual. Insome embodiments of the present invention, the cortex of the individualwhich is receiving the neuronal stimulation signal (i.e. via afferentaction potentials of the stimulated afferent axons 230) may associatethe corresponding sensory percept with a movement cue and/or other typeof movement related information such as proprioceptive informationrelating to the body posture of the individual operating the neuronalstimulation system. For example, similar to learning how to understandMorse code, the individual may have previously participated in alearning procedure establishing an associative link between a givensensory percept elicited by a given stimulation signal and acorresponding movement cue (see FIGS. 5 and 6 below) or a piece ofproprioceptive information (e.g. see FIGS. 8 and 9 below) that is to becommunicated to the individual via the neuronal stimulation electrode120.

In this approach no nuclei or neuron-rich grey matter are preferablytargeted by the neuronal stimulation electrode 120 but preferably theaxon-rich white matter of the brain, which contains the informationtransmitting pathways the brain uses for natural neural communication.In this manner, the present invention provides a white-mattercomputer-brain-interface (CBI), i.e. a system that generates andprovides electrical signals the brain can interpret as meaningful input,e.g. as a rhythmic movement cue or any other type of movement relatedinformation such as a commence movement trigger (e.g. a FOG break-outsignal) or information about the current body posture of the individual(e.g. proprioceptive information). As discussed in section 3 above, suchinformation may be provided by different types of measurement devices orsensors (see also FIG. 7).

In other embodiments of the present invention, the neuronal stimulationelectrode 120, the signal generator 110 and/or the wireless interfacemay also be part of an integrated neuronal stimulation and/orcommunication system, e.g. if said components are customized for theintended application. For instance, a neuronal communication system maycomprise of specialized communication software running on amulti-purpose information processing device such as a smartphone and acustomized assembly of signal generator 110 and stimulation electrode120 which communicate with the multi-purpose communication device via awireless interface using conventional wireless data transmissiontechnology such as Wi-Fi, Bluetooth and/or NFC.

In other embodiments of the present invention the neuronal stimulationelectrode 120 may be directly connected via wires to a neuronalstimulation system comprising a data processing system and a signalgenerator similar to the signal generator no. In this case a wirelessinterface is not needed.

FIG. 3 depicts of a multi-contact neuromodulation electrode 120 adaptedfor neuromodulation of the sub-thalamic nucleus 320 via electriccontacts 330. The electrode 120 can also be used for stimulatingafferent axons 342, 344 projecting from the thalamus 310 to the sensorycortex of an individual via a neuronal stimulation system according tothe present invention. For example, neuronal stimulation signals may beprovided by unused contacts 340, 350 of the neuromodulation electrode120 that was implanted for a therapeutic purpose (e.g. neuromodulationof the subthalamic nucleus 320 via the therapeutic electric contacts330) different from providing the neuronal stimulation signal to theafferent sensory axons 344, 342. For instance, the contacts that are notused for neuromodulation of the sub-thalamic nucleus 320 may be used toprovide a sensory movement cue and/or proprioceptive information to thecortex of the individual. An example of such a sensory movement cue maybe a rhythmic sensory percept elicited by a neuronal stimulation signalapplied to the axons 344 targeting a cortex area related to a touchsensation for instance in the left foot.

In many cases, a DBS electrode 120 that is used as a neuromodulator,e.g. for treatment of PD symptoms, is not always active and/or maycomprise independently controllable contacts that are not required forachieving the therapeutic purpose. Thus, the neuromodulation electrodecan also be used for applying neuronal stimulation signals provided by asystem according to the present invention. For DBS electrodes,specifically, some of the electrode contacts located outside of thestimulation area of interest are not used. However, if implantation ine.g. the subthalamic nucleus 320 is conducted for the tip contacts 330to control, for example, the primary PD symptoms more distal contacts340, 350 could be used in combination with the above disclosed inventionto communicate a movement cue and/or a continuous movement biofeedbacksignal into the brain the patient can utilize to navigate better and/orbreak free from FOG.

FIG. 4A depicts is a block diagram of a neuronal stimulation signalgenerator 110 which can be used to apply neuronal stimulation signals toafferent axons 230 via a neuronal stimulation electrode such as thestimulation electrode 110 of FIGS. 1-3. The neuronal stimulation signalgenerator 110 may comprise a wireless interface 410 for communicatingwith a remote neuronal stimulation system (e.g. see FIG. 4B) which maybe adapted to obtain, to determine, to select and/or to transmit awaveform and/or signal parameter of the neuronal stimulation signal tothe signal generator 110 in order generate a neuronal stimulation signaladapted to elicit a desired sensory percept associated with a movementcue (see FIGS. 5 and 6) and/or proprioceptive information (see FIGS. 8and 9).

For instance, the neuronal stimulation signal generator 110 may receivedigital data packets specifying a desired neuronal stimulation signalvia the wireless interface 410. Receiver (RX) circuitry may process(e.g. filter, amplify, mix, down-convert to baseband etc.) the receiveddigital data packets and feed the processed digital data packets to adigital signal processor (DSP) with may comprise an integrateddigital-to-analog converter (DAC). The DSP then processes the digitaldata packets to generate one or more neuronal stimulation signals whichmay then be amplified and applied to a neuronal stimulation electrodesuch as electrode 120 of FIG. 2 and FIG. 3 by an output amplifier (AMP).For instance, the output AMP may be configured to drive four (or anyother number) independently controllable electric contacts 330, 340, 350of a stimulation electrode such as electrode 120 via the output wires420.

In other embodiments, the DSP may receive the digital data packetsspecifying the neuronal stimulation signal also via a wire-basedinterface or directly from a collocated processing circuit (e.g. a CPU)which may be adapted to determine the waveform and/or signal parametersof a desired neuronal stimulation signal corresponding to a desiredsensory movement cue and/or proprioceptive information to be elicited inthe cortex of the to the individual.

FIG. 4B depicts a block-type circuit diagram of an exemplary neuronalstimulation system 400 according to an embodiment of the presentinvention. The neuronal stimulation system 400 may for instance comprisea wireless interface 412 and transmitter (TX) circuitry forcommunicating (e.g. via Bluetooth or a similar interface) with aneuronal stimulation signal generator such as the generator circuit 110described above with reference to FIG. 4A. The TX circuitry may beadapted to process (i.e. filter, modulate, mix, amplify, and/orupconvert) digital data packets to be communicated via the wirelessinterface 412. The neuronal stimulation system 400 may further comprisea digital signal processor (DSP) operably connected with the TXcircuitry and adapted to provide digital data packets specifying thewaveform and/or the signal parameters (e.g. frequency, phase, pulsewidth, pulse amplitude, pulse shape, channel count, etc.) of a desiredneuronal stimulation signal to be applied via a neuronal stimulationelectrode such as the electrode 120 of FIGS. 2 and 3 and via a neuronalstimulation signal generator such as signal generator 110 of FIG. 4A.

The neuronal stimulation system 400 may further comprise general dataprocessing circuitry such as a CPU operably connected to the DSP and atleast one digital memory device operably connected to the CPU. The CPU320 and the memory may interact to determine a desired neuronalstimulation signal corresponding to a desired sensory percept such asthe desired movement cue and/or the desired proprioceptive informationto be communicated to the cortex of the individual.

For instance, the memory may contain a personalized communicationlibrary for the individual, the library storing relations between aplurality of movement cues and/or perceptive information blocks and aplurality of corresponding neuronal stimulation signals.

Such a stimulation library can be calibrated for each individual throughneuroimaging and/or individualized testing of the individual.Neuroimaging may first be used to identify theoretically possible rangesof activation for an individual stimulation electrode whileindividualized testing determines which points in the parameter space ofstimulation signal parameters (for details see FIG. 5 and FIG. 8 below)can be perceived and decoded by the cortex of the individual. It shouldbe emphasized that conscious individualized testing of an individual ismerely one specific example how to generate the individualized relationsstored in the memory. In other embodiments such relations may also beobtained from unconscious patients, e.g. through the non-invasiveobservation of corresponding functional MRI responses on thesomatosensory cortex or EEG recordings.

Further, once or while the communication library (i.e. the plurality ofrelations stored in the memory) is established or is being establishedfor an individual a specific training procedure can be executed (againnot necessarily in a conscious individual). As long as the cortex of theindividual responds to classical conditioning, pair learning can beexecuted. In the context of the present invention, such a pair consistsof a given sensory percept corresponding to a given neuronal stimulationsignal and a movement cue and/or a piece of proprioceptive informationto be associated with said given sensory percept and the correspondingneuronal stimulation signal.

Importantly, the type of information to be conveyed via the neuronalstimulation system 400 whether it is a movement cue, a FOG breakoutsignal or a piece of proprioceptive information can be chosen freely.Any information or message which can be broken down into message blocks(i.e. pieces of conceptual information that can be decoded by the cortexof an individual) can be transmitted. This includes continuous signalssuch as signals needed for e.g. an artificial balance, orientationsignals or other sensor measurement signals.

Learning paradigms for continuous signals deviate from classicalconditioning, since they involve more interactive training scenarioswhere utilization of the signal is a relevant success factor (e.g.orientation in an artificial virtual environment using the inputsignal). Continuous signals (e.g. intensity) also deviate from signalconfigurations for messages containing sequentially delivered messageblocks. In the case of continuous signals, intensity might be coded viaeither pulse width or frequency variations (or combinations of the two;see FIG. 8 below), while not varying the location and target areas inthe sensory cortex targeted by the recruited axon fibers.

FIGS. 5 and 6 illustrates how embodiments of the present invention canbe used to establish a sensory movement cueing channel to the to thecortex of an individual and to use said cueing channel to provide aperiodic movement cue and a FOG break-out signal that may be used forbehavior modification, e.g. to support the individual during a walkingtask.

For instance, three different walking paces (e.g. 1 step per second, 0.5steps per second, 2 steps per second) may be encoded by providing apulse train signal via a neuronal stimulation interface and system asdiscussed above. Such a pulse train (being characterized by signalparameters such as pulse width, pulse frequency, pulse shape and/orpulse amplitude) may elicit a periodic/rhythmic sensory percept in thetargeted area of the sensory cortex of the individual. For instance,such a pulse train signal may be configured to elicit a periodicallyappearing tough sensation in the palm of the right hand or in a leg ofthe individual. Similar to an auditory movement cue provided to theindividual via earphones such a neuronal movement cue may help theindividual to walk at a constant pace and without experiencing a FOGperiod. Moreover, the same neuronal communication channel can also beused to communicate a FOG breakout signal to the individual. Forinstance, the FOG breakout signal may be encoded by choosing a differentcombination of pulse train parameters such as a combination of a largerpulse frequency and a larger pulse width as indicted in FIG. 5.

FIG. 6 illustrates a typical use scenario of a neuronal stimulationsystem provided by the present invention. When occurrence of a FOG eventhas been determined (either by the neuronal stimulation system itself, ahuman supervisor or a control device associated with the individualperforming the walking task) the neuronal stimulation system may obtainthe FOG breakout signal (e.g. from its memory or via a wirelesscommunication interface) and transmits it to an electric contact of aneuronal stimulation electrode such as the DBS electrode illustrated inFIGS. 2 and 3 to suppress the FOG event.

After a FOG event has been suppressed the neuronal stimulation systemcan switch into a pacemaker operation mode and may apply a slow periodicmovement cue to help the individual to resume normal walking. After theindividual has resumed slow walking he could provide a user input to theneuronal stimulation system indicating the intention to switch from theslow movement cue to a faster one.

Such user input may for example be provided via a control device such asa smartphone or via a neuronal excitation measurement equipmentrecording a neuronal excitation pattern corresponding to a motor intentof the individual. For instance, such a neuronal excitation measurementequipment may involve recoding from the contacts of the same neuronalelectrode that is also used for applying the neuronal stimulation signal(e.g. in the form of Local Field Potentials). In some embodiments thesystem may also comprise an EEG device, a sub-dural electrode arrayand/or a transcranial excitation measurement device.

Such neuronal excitation measurement equipment may be used to providethe individual with an essentially closed loop stimulation system,wherein measurements motor related neuronal excitation patterns directlyaffect how the neuronal stimulation system is operating.

FIG. 7 depicts an individual 100, e.g. a PD patient, having beenimplanted with a neuronal stimulation electrode 120 such as a DBSelectrode that may have multiple independently controllable electriccontacts, as illustrated in FIG. 3. In addition to the devices discussedabove with reference to FIG. 1 the individual 100 may further beequipped with sensors 710 and 720 that are configured to obtaininformation on the body posture of the individual 100. For instance,sensor 710 may be configured to measure the balance of the body of theindividual 100 while the sensors 720 may be configured to measure thearticulation state/flexing angle of the knee joints of the individual100.

The sensors 710, 720 may be in wireless communication with the neuronalsignal generator 110, the control device 130 and/or a neuronalstimulation system similar to the one discussed above with reference toFIG. 4B.

The measurement signals (providing information about the body posture ofthe individual 100) may be transmitted by the sensors 710 and 720 to theprocessing means of a neuronal stimulation system. The system may thendetermine, based on the obtained information, a neuronal stimulationsignal to be applied to at least one afferent axon targeting at leastone sensory neuron in the cortex of the individual, wherein thedetermined neuronal stimulation signal corresponds to proprioceptiveinformation that is communicated to the individual.

For instance, as illustrated in FIG. 8 and FIG. 9 neuronal stimulationsystem may use the measurements of the knee joint sensors 720 todetermine a neuronal stimulation signal that is adapted to communicatethe articulation state of the knee joint to the cortex of theindividual. As shown in FIG. 8, the articulation state of the knee jointmay be encoded by a combination of signal parameters such as pulse widthand pulse frequency of a pulse train signal. In the example shown inFIG. 8 a low frequency pulse train having a short pulse width (A)corresponds to a knee joint that is essentially fully stretched out (A)whereas a high frequency pulse train having a long pulse width (D)corresponds to a knee joint that is almost fully bent (D).

FIG. 10 illustrates how the movement cueing channel of FIGS. 5 and 6 andthe proprioceptive information channel of FIGS. 8 and 9 can be combinedto improve the performance of a neuronal stimulation system intended fortreatment of movement impairments. In the illustrated example a neuronalstimulation signal that is providing the joint articulation stateinformation (e.g. the proprioceptive information channel) is appliedquasi-continuously while the individual performs a movement (e.g.walking, dancing etc.) paced by the movement cue signal. If theindividual walks synchronized with the movement cue signal every time amovement cue pulse is perceived by the individual the joint articulationsignal communicates a fully stretched state (A) of the knee joint to theindividual. Between two movement cue pulses the knee joint of theindividual first bends (A-B-C-D) and then stretches out again (D-C-B-A).

Compared to systems that only provide movement cues a system providingboth, a m movement cue and proprioceptive information together to thecortex of an individual substantially improves the movement performanceof the individual because synchronizing the movement of the individualwith an external movement cue is much easier if proprioceptiveinformation is provided as feedback to the brain that indicates thephase of the movement relative to the timing of the movement cue.

1. A system for stimulating the sensory cortex of an individual,comprising: a. a processor coupled to a non-transitory memory, whereinthe non-transitory memory stores one or more neuronal stimulationsignals adapted to provide a movement cue for the individual; b.transmitter circuitry coupled to the processor and configured totransmit a first neuronal stimulation signal of the one or more neuronalstimulation signals to an electric contact of a neuronal stimulationelectrode implanted into the brain of the individual.
 2. The system ofclaim 1, wherein the neuronal stimulation electrode is already implantedinto the brain of the individual for a purpose different from providingthe movement cue.
 3. The system of claim 2, wherein the neuronalstimulation electrode is implanted for the purpose of at least one of:a. deep brain stimulation; b. neuronal sensing; c. an open-loop orclosed-loop combination of deep brain stimulation and neuronal sensing;d. treatment of one or more of Parkinson's disease, epilepsy, dystoniaor tremor; e. neuronal communication.
 4. The system of claim 2, whereinthe electric contact is not being used for the purpose different fromproviding the movement cue.
 5. The system of claim 2, wherein the systemfurther comprises circuitry for operating the neuronal stimulationelectrode according to the purpose that is different from providing themovement cue.
 6. The system of claim 1, wherein the first neuronalstimulation signal comprises a signal or a pulse train signal designedto be perceived by the individual as periodic.
 7. The system of claim 1,wherein the transmitter circuitry is further configured to control oneor more of a frequency, a pulse width, a pulse shape or an amplitude ofthe first neuronal stimulation signal.
 8. The system of claim 7, whereinthe transmitter circuitry is further configured to control one or moreof the movement speed, pace regularity or balance of the individual viaone or more of the frequency, the pulse width, the pulse shape or theamplitude of the first neuronal stimulation signal.
 9. The system ofclaim 1, wherein the processor is further configured to select the firstneuronal stimulation signals to be transmitted to the electric contactneuronal stimulation electrode.
 10. The system of claim 9, wherein theprocessor is further configured to select a second neuronal stimulationsignal of the one more neuronal stimulation signals having a differentfrequency than the first neuronal stimulation signal for transmission tothe electric contact neuronal stimulation electrode.
 11. The system ofclaim 10, wherein the first neuronal stimulation signal is adapted tocontrol one or more of the movement speed, the pace regularity or thebalance of the individual and the second neuronal stimulation signal isadapted to counteract a temporary movement impairment of the individual.12. The system of claim 1, wherein the transmitter circuitry is furtherconfigured to transmit at least two different neuronal stimulationsignals to two different contacts of the neuronal stimulation electrodeat substantially the same time.
 13. The system of claim 1, wherein thefirst neuronal stimulation signal is adapted to elicit a conscioussensory percept in the cortex of the individual.
 14. The system of claim13, wherein the sensory percept is elicited in at least one of: a. asomatosensory cortex area; b. a visual cortex area; c. an auditorycortex area.
 15. A system for communicating proprioceptive informationto an individual, comprising: one or more sensors configured to obtaininformation about the body posture of the individual; a processorcoupled to a non-transitory memory, wherein the processor is configuredto determine, based on the obtained information, a neuronal stimulationsignal to be applied to at least one afferent axon targeting at leastone sensory neuron in the cortex of the individual, wherein thedetermined neuronal stimulation signal corresponds to the proprioceptiveinformation to be communicated; and transmitter circuitry configured totransmit the determined neuronal stimulation signal to a neuronalstimulation electrode of the individual adapted to apply the determinedneuronal stimulation signal to the at least one afferent axon.
 16. Thesystem of claim 15, wherein the information about the body posture ofthe individual comprises at least one of: a. information about anarticulation state of a joint of the individual; b. information about aflexing angle of a joint of the individual; c. information about thebalance of the body of the individual; d. information about a tone of amuscle of the body of the individual; e. information about a position ofa part of the body of the individual with respect to a referenceposition; f. information about a surface contact of a part of the bodyof the individual.
 17. The system of claim 15, wherein the one or moresensors for obtaining information about the body posture of theindividual comprise one or more of: a. a pressure sensor; b. a tensionsensor; c. a balance sensor; d. an acceleration sensor; e. a temperaturesensor; f. an image sensor; g. a force sensor; h. a distance sensor; i.an angle sensor; and j. a speed sensor.
 18. The system of claim 15,wherein the processor is further configured to access relations storedon the non-transitory memory, wherein the relations are specific for theindividual, wherein the relations comprise relations between a pluralityof proprioceptive information and a plurality of corresponding neuronalstimulation signals.
 19. The system of claim 18, wherein the relationsare based at least in part on proprioceptive learning data for theindividual, wherein the learning data associates the plurality ofproprioceptive information with the plurality of corresponding neuronalstimulation signals.
 20. The system of claim 15, wherein the neuronalstimulation signal is configured to elicit a conscious or a subconscioussensory percept in the cortex of the individual.
 21. A system forcommunicating movement information to an individual, comprising: firsttransmitter circuitry configured to: provide a first neuronalstimulation signal to be applied to the cortex of an individual andadapted to provide movement information for the individual; and providea second neuronal stimulation signal to be applied to the cortex of theindividual and adapted to provide proprioceptive information to theindividual, wherein the first and the second neuronal stimulationsignals are adapted to be applied together to the cortex of theindividual.
 22. The system of claim 21, wherein one or more of the firstand second neuronal stimulation signals are applied via at least oneportion of a neuronal stimulation electrode already implanted for apurpose different from the communicating of the movement information.23. The system of claim 21, wherein the proprioceptive information isrelated to a body part of the individual involved in a movement of theindividual associated with the movement information.
 24. The system ofclaim 21, wherein the second neuronal stimulation signal is adapted toprovide one or more of the following information: a. information aboutan articulation state of a joint of the individual; b. information abouta flexing angle of a joint of the individual; c. information about thebalance of the body of the individual; d. information about a tone of amuscle of the body of the individual; e. information about a position ofa part of the body of the individual with respect to a referenceposition; and f. information about a surface contact of a part of thebody of the individual.
 25. The system of claim 21, wherein thetransmitter circuitry is adapted to control one or more of a frequency,a pulse width, a pulse shape and or an amplitude of one or both of thefirst and second neuronal stimulation signals and/or a relative timingbetween the first and the second neuronal stimulation signals.
 26. Thesystem of claim 25, wherein the second neuronal stimulation signal isadapted to be provided at a rate that is more than 20 times larger thana frequency of the first neuronal stimulation signal.
 27. The system ofclaim 26, wherein the second neuronal stimulation signal is adapted tobe provided quasi-continuously with respect to the first neuronalstimulation signal.
 28. The system of claim 21, the system furthercomprising one or more sensors configured to obtain information aboutthe body posture of the individual, wherein the one or more sensorscomprise one or more of: a. a pressure sensor; b. a tension sensor; c. abalance sensor; d. an acceleration sensor; e. a temperature sensor; f.an image sensor; g. a force sensor; h. a distance sensor; i. an anglesensor; and j. a speed sensor.
 29. The system of claim 28, wherein theone or more sensors are integrated into one or more of: a. a piece ofapparel, b. a piece of footwear, c. a prothesis, d. an orthosis, e. anexoskeleton, f. an autonomous robotic companion, g. a wearableelectronic device, and h. an implanted device.
 30. The system of claim21, further comprising a computing device configured to receive aneuronal measurement signal corresponding to a neuronal excitationpattern recorded via a neuronal excitation measurement device.
 31. Thesystem of claim 30, wherein the neuronal excitation pattern correspondsto one or more of a movement intention and motor-sensory information ofthe individual.
 32. The system of claim 30, wherein the neuronalmeasurement signal is received from at least one of the following: a. anelectroencephalography, EEG, device; b. a neuro-electrode; c. a deepbrain stimulation electrode; d. a sub-dural electrode; e. a sub-duralelectrode array; f. a connected wearable device; and g. a transcranialexcitation measurement device.
 33. An electronic information processingdevice, comprising: a processor coupled to a non-transitory memory,wherein the non-transitory memory stores one or more neuronalstimulation signals adapted to provide a movement cue for theindividual; transmitter circuitry coupled to the processor andconfigured to transmit a first neuronal stimulation signal of the one ormore neuronal stimulation signals to an electric contact of a neuronalstimulation electrode implanted into the brain of the individual.
 34. Adistributed electronic information processing system, comprising: one ormore sensors configured to obtain information about the body posture ofan individual; a processor coupled to a non-transitory memory, whereinthe processor is configured to determine, based on the obtainedinformation, a neuronal stimulation signal to be applied to at least oneafferent axon targeting at least one sensory neuron in the cortex of theindividual, wherein the determined neuronal stimulation signalcorresponds to the proprioceptive information to be communicated; andtransmitter circuitry configured to transmit the determined neuronalstimulation signal to a neuronal stimulation electrode of the individualadapted to apply the determined neuronal stimulation signal to the atleast one afferent axon.
 35. A computer program, comprising programinstructions which, when executed by an electronic informationprocessing device or a distributed electronic information processingsystem, cause transmitter circuitry to: provide a first neuronalstimulation signal to be applied to the cortex of an individual andadapted to provide movement information for the individual; and providea second neuronal stimulation signal to be applied to the cortex of theindividual and adapted to provide proprioceptive information to theindividual, wherein the first and the second neuronal stimulationsignals are adapted to be applied together to the cortex of theindividual.
 36. A computer program, comprising program instructionswhich, when executed by an electronic information processing device or adistributed electronic information processing system, cause a processorto: obtain information about the body posture of an individual from oneor more sensors; determine, based on the obtained information, aneuronal stimulation signal to be applied to at least one afferent axontargeting at least one sensory neuron in the cortex of the individual,wherein the determined neuronal stimulation signal corresponds toproprioceptive information to be communicated; and cause transmittercircuitry to: transmit the determined neuronal stimulation signal to aneuronal stimulation electrode of the individual adapted to apply thedetermined neuronal m stimulation signal to the at least one afferentaxon.
 37. A computer program, comprising program instructions which,when executed by an electronic information processing device or adistributed electronic information processing system, cause a processorto: obtain a first neuronal stimulation signal from one or more neuronalstimulation signals stored on non-transitory memory, wherein the one ormore neuronal stimulation signals are adapted to provide a movement cuefor an individual; and cause transmitter circuitry to: transmit thefirst neuronal stimulation signal to an electric contact of a neuronalstimulation electrode implanted into the brain of the individual.